Using Newly Linked Data to Assess Equity of Out-Of-Pocket Healthcare Costs in Australia

Abstract

Introduction Describing out-of-pocket (OOP) healthcare costs in relation to ability to pay requires multiple linked data sources not previously available. Current estimates of the progressivity of OOP healthcare costs in Australia are based on self-report surveys. Using newly linked Census to administrative income and medical claims data, we aimed to quantify, for the first time, the progressivity of OOP costs for government-subsidised out-of-hospital healthcare in Australia. Objectives and Approach We used Australian Census 2011 linked to Personal Income Tax (PIT), Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data compiled through the Multi-Agency Data Integration Project (MADIP). Personal disposable income was estimated using a combination of PIT data and Census self-reported income, and aggregated across the household to estimate equivalised household income. We estimated annual MBS (out-of-hospital only) and PBS OOP costs as a proportion of equivalised household income, and assessed progressivity by reporting this for each income decile and computing a Kakwani Index. Results We will present findings on progressivity overall, and separately by age, sex and location (incomplete at time of abstract submission). Conclusion / Implications Our study will present one measure regarding the equity of healthcare costs, and help to identify vulnerable or at-risk groups. These findings may inform policy changes on equity in the financing of healthcare. Newly linked data from the MADIP can be used to relate healthcare costs to ability to pay.